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Dr. Shawn Smit:  Impaired Physician

Borderline Violence, Adversarial Dynamic

Dr. Smit:  Idylwyld Medical Centre

Dr. Shawn Smit

Family Physician
Idylwyld Medical Centre
1216 Idylwyld Drive North
Saskatoon, Canada

Emigrated from South Africa

Medical School: University of Pretoria
(Independent verification not possible)

College of Physicians and Surgeons:
Dr. Shawn Smit Profile

Easy Access Creates Risk

Physicians have easy access to drugs of abuse, either when administering treatment to patients, or by self-prescription. There are consequences to easy access: Over their practice lifetime, 8% - 12% of physicians will experience a substance related problem. This is the most common reason for disciplinary action by State Medical Boards in the USA.

The impaired physician often retains the ability to protect his or her practice performance at the expense of other dimensions of life. Social, family, and emotional problems will often occur prior to career impairment. Frequently, substance abuse pre-dates admission to medical school.

No single sign signifies impairment. Collectively, however, the signs may define a pattern, warning of a potential problem. Colleagues are required to immediately report any good faith suspicion or concern about an impaired professional. The information is treated confidentially to the extent allowed by law. Good faith reports of possible impairment can be made without fear of retaliation.

Recognizing Impairment:  Behavioral and Career Clues

Dr. Shawn Smit Behavioral Clues
Outbursts of anger
Incongruous expressions of libido
Poor memory, poor concentration
Declining performance in career
  Drinking or driving under the influence (DUI)
Dr. Shawn Smit Career Warning Signs
Neglect of patients or duties
Inappropriate treatment or orders
Patient complaints increase
  Excessive absenteeism
  Sleeping or dozing on duty
  Appointments or schedule disorganized
  Hard to locate; does not respond to pages or calls

Patient Log:  May 21, 2013

Dr. Shawn Smit
GP Dr. Shawn Smit
Idylwyld Clinic, Saskatoon

Family physician Dr. Shawn Smit practices at the Idylwyld Medical Centre in Saskatoon. Over the past two years Dr. Smit maneuvered a complete role reversal with me in our doctor-patient relationship. I shoulder the workload because Dr. Smit cannot or will not do the work himself. If I don't turn up information and ideas, then my medical care stands still.

Dr. Smit enjoys the role of being a doctor, and the power it confers. Unfortunately, he has no affinity for science. He is bored by science, indifferent to it. This GP perches on his chrome chair, his posture dispirited, his face a portrait of utter misery, because he cannot wrap his mind around the technical topic depicted on the research abstract or textbook page I just handed him.

His misery has naught to do with how patients conduct themselves. For myself, I appease and placate Dr. Smit, and offer compassion and several thank-you's per visit. This route became necessary to fend off his borderline violence.

The only question that matters is whether you continue to climb the learning curve.

At my appointment today, Dr. Smit was suddenly preoccupied with patients trusting him. In a tone that alternately browbeat and wheedled, Dr. Smit reiterated this theme, claiming that when a patient looks up topics on the internet, it means the patient doesn't trust what he says.

He trolled that fishing line several times. He also fished for compliments: In a loud, self-absorbed voice he asked me whether I believed he had adequate knowledge. I replied: The only question that matters is whether you continue to climb the learning curve. I added: As a physicist, I place the same requirement on myself.

There is a dichotomy:  Dr. Smit rages when I read medical subjects on the internet, then turns around and simultaneously holds out his hand for the next installment of print-outs from my internet search for information to guide what to do next.

Dr. Smit's anger is really angst: He fears I will learn from independent sources that his medical advice – except on the most trivial of topics – is misinformed. His memory problems are so severe that almost everything he says is the opposite of what the textbooks say.

His wish for blind trust focuses on two chief areas:

1.Issue: Dr. Shawn Smit wants to persuade patients that statin side-effects are increasingly seen as exaggerated. Statins are a class of medicine used to treat high-cholesterol.
Rebuttal: The opposite is true. The FDA increasingly recognizes statin risks. The list of adverse events now includes muscle damage (with or without pain), exertional fatigue, Type 2 diabetes, and CNS side-effects. The FDA at first believed the risks were impossible, until research into glial cells, for example, showed how statins can induce cognitive deficit in the brain. The FDA stopped denying the risks, and now acknowledge and publish cautions.
2.Issue: Dr. Shawn Smit wants to persuade patients that Lipase can be zero without causing symptoms. Lipase is a pancreatic enzyme.  Our Saskatoon blood-test laboratory sets the normal range for Lipase at 22–51 Units/Liter.  But Smit claims we can act as if the normal range for Lipase actually begins at zero because some labs in the world begin their normal range at zero.
Rebuttal: Fasting Lipase can be low, but thirty minutes after a meal this digestive enzyme should peak. A graph would show a linear rise above the basal value. Failure of Lipase to rise post-meal signifies pancreatic insufficiency – a serious condition. Our body relies on Lipase to digest fats, specifically to split fatty acids off triglycerides.
It is crucial to to use the reference range (normal range) printed on your own lab sheet. Labs customize their own reference range for each test. Different labs buy diverse brands of machinery; they mix the blood sample with different reagents; they follow variants of test protocols. For this reason, the reference range can vary widely between different labs. It is appallingly negligent for a doctor to swap his local lab's normal range for some other range that he read on a blog.
Elevated Cholesterol and Triglycerides often have a genetic cause. One mechanism is mutation of the Lipase gene. Defects in this gene can decrease the rate of Lipase production in the pancreas. A defective gene may also alter the structure of the Lipase molecule, rendering it less active. The quantity and quality of Lipase both matter.

Boundary Violation

Dr. Shawn Smit
Saskatoon GP Dr. Shawn Smit

During the most intimidating 15 minutes today, Dr. Shawn Smit committed a boundary violation. His posture, normally unremarkable, was now coarse and vulgar. The event was visual (not physical) at the low end of the spectrum – but was accompanied by a domineering voice tinged with glee.

The timing was precise: The event occurred over the minutes when he thought he had successfully run a scam on me – telling me that even Hepatobiliary specialists would say low-Lipase doesn't matter.

During previous appointments, I sensed that Dr. Smit got pleasure out of wounding and deceiving people. Today I saw he gets so much pleasure in destruction that his emotions cross the boundary into a sexual charge. [Insight thanks to journalist and author Michael Connelly, source Blood Work.]

After this day's appointment, the accumulated events left me feeling shell-shocked for the next three weeks. Smit's senseless anger was draining, and a sense of betrayal incurs when a family physician is capable of malicious intent.

Georgena S. Sil
Saskatoon, Canada
Physicist & Technical Writer
Alumnus: University of British Columbia

Copyright © 2008-2018 Georgena Sil. All Rights Reserved.